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https://www.readbyqxmd.com/read/29650125/restenosis-stent-thrombosis-and-bleeding-complications-navigating-between-scylla-and-charybdis
#1
REVIEW
Juan Torrado, Leo Buckley, Ariel Durán, Pedro Trujillo, Stefano Toldo, Juan Valle Raleigh, Antonio Abbate, Giuseppe Biondi-Zoccai, Luis A Guzmán
The field of interventional cardiology has significantly evolved over 40 years by overcoming several challenges. The introduction of first-generation drug-eluting stents significantly reduced the rates of restenosis, but at the expense of an increase of late stent thrombosis. Prolonged antithrombotic therapy reduced rates of stent thrombosis, but at the cost of increased bleeding. Although the advent of second-generation drug-eluting stents subsequently reduced the incidence of late stent thrombosis, its permanent nature prevents full recovery of vascular structure and function with accordant risk of very late stent failure...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#2
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29629708/dipyridamole-loaded-biodegradable-pla-nanoplatforms-as-coatings-for-cardiovascular-stents
#3
Veroniki Bakola, Varvara Karagkiozaki, Aikatherini-Rafailia Tsiapla, Foteini Pappa, Ioannis Moutsios, Eleni Pavlidou, Stergious Logothetidis
Cardiovascular Stents are commonly used for the treatment of Cardiovascular Diseases (CVDs) that in developed societies, are the most frequent causes of mortality and morbidity. Recent years, thorough research and development of Drug Eluting Stents (DES) has been done, with emphasis on coronary stenting to avoid the most common complication, the in-stent thrombosis. Dipyridamole (DPM) is a medication that inhibits blood clot formation. Drug Delivery Nanoplatforms consisting of biodegradable polymers can be fabricated via Electrospinning Deposition, known for its cost-effective and versatile advantages, that produces fibrous scaffolds able of sustainable and controllable drug release...
April 9, 2018: Nanotechnology
https://www.readbyqxmd.com/read/29627909/technological-advances-in-stent-therapies-a-year-in-review
#4
REVIEW
Jad Raffoul, Ammar Nasir, Andrew J P Klein
Stent technology has rapidly evolved since the first stainless steel bare metal stents with substantial developments in scaffolding, polymer, drug choice, drug delivery, and elution mechanisms. Most recently, there has been the evolution of bioabsorbable vascular scaffolds, potentially eliminating the need for long-term foreign object retention. These rapid developments have led to an ever-expanding selection of new stents, making the choice of which to use in which patient challenging. Operators must balance potential short- and long-term clinical ramifications, namely stent thrombosis, in-stent restenosis, target lesion revascularization, and target lesion failure...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29626150/rac1-modulates-endothelial-function-and-platelet-aggregation-in-diabetes-mellitus
#5
Gabriele Giacomo Schiattarella, Albino Carrizzo, Federica Ilardi, Antonio Damato, Mariateresa Ambrosio, Michele Madonna, Valentina Trimarco, Marina Marino, Elena De Angelis, Silvio Settembrini, Cinzia Perrino, Bruno Trimarco, Giovanni Esposito, Carmine Vecchione
BACKGROUND: Vascular complications and abnormal platelet function contribute to morbidity and mortality in diabetes mellitus. We hypothesized that the Rho-related GTPase protein, Rac1, can influence both endothelial and platelet function and might represent a potential novel therapeutic target in diabetes mellitus. METHODS AND RESULTS: We used both in vitro and ex vivo approaches to test the effects of pharmacological inhibition of Rac1 during hyperglycemic condition...
April 6, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29625210/application-of-quality-by-design-to-optimize-a-stability-indicating-lc-method-for-the-determination-of-ticagrelor-and-its-impurities
#6
Nathalie R Wingert, Jéssica B Ellwanger, Lívia M Bueno, Caren Gobetti, Cássia V Garcia, Martin Steppe, Elfrides E S Schapoval
Simultaneous analysis of drug compounds and their impurities of degradation and synthesis became constant in the modern pharmaceutical analysis. Likewise, analytical techniques must improve sensitivity and selectivity for the monitoring of pharmaceutical products, allowing a full assessment of impurities in drug products and, therefore, ensure safety and efficacy of pharmacological treatments. The application of Quality by Design (QbD) principles has proved to be feasible on the elaboration of analytical methods, allowing the comprehensive evaluation and measurement of different analytical parameters and their effects on critical properties of the methodology in development...
April 3, 2018: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29624770/hot-off-the-press-topical-tranexamic-acid-compared-with-anterior-nasal-packing-for-treatment-of-epistaxis-in-patients-taking-antiplatelet-drugs
#7
Justin Morgenstern, Sahaana Rangarajan, Corey Heitz, Chris Bond, William K Milne
This is a non-blinded, randomized controlled trial comparing topical TXA and anterior nasal packing in the treatment of anterior epistaxis in patients on antiplatelet medications whose bleeding persisted despite 20 minutes of pressure. Patients were randomized to either TXA (a cotton pledget soaked with 500 mg of TXA and inserted into the affected nostril until hemostasis was achieved) or anterior nasal packing (pretreatment with a cotton pledget soaked in epinephrine and 2% lidocaine for 10 minutes followed by anterior nasal packing with tetracycline ointment left in situ for 3 days)...
April 6, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29622141/clinical-angiographic-and-procedural-correlates-of-very-late-absorb-scaffold-thrombosis-multistudy-registry-results
#8
Stephen G Ellis, Tommaso Gori, Patrick W Serruys, Holger Nef, Giuseppe Steffenino, Salvatore Brugaletta, Thomas Munzel, Cordula Feliz, Götz Schmidt, Manel Sabaté, Yoshinobu Onuma, R J van Geuns, Run-Lin Gao, Maurizio Menichelli, Dean J Kereiakes, Gregg W Stone, Luca Testa, Takeshi Kimura, Alexandre Abizaid
OBJECTIVES: The aim of this study was to identify independent correlates of very late scaffold thrombosis (VLST) from an analysis of consecutively treated patients from 15 multicenter studies. BACKGROUND: Recent analyses suggest an increased risk for VLST with the Absorb Bioresorbable Vascular Scaffold compared with drug-eluting stents, but insights as to correlates of risk are limited. METHODS: A total of 55 patients were identified with scaffold thrombosis...
April 9, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29618159/early-p2y12-inhibitors-escalation-in-primary-pci-patients-insights-from-the-renovami-registry
#9
Alessandro Lupi, Roberta Della Bona, Emanuele Meliga, Davide Capodanno, Alon Schaffer, Angelo S Bongo, Giovanni Gaudio, Luigina Guasti, Dimitrios Alexopoulos, Marco Valgimigli, Italo Porto
BACKGROUND:  Early escalation from clopidogrel to new generation P2Y12 inhibitors is common practice in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Real-world data about this strategy, however, are limited. METHODS:  From 2012 to 2015, 1,057 consecutive STEMI patients treated with pPCI in an Italian hub-and-spoke network were prospectively included in an observational registry (RENOVAMI, ClinicalTrials...
April 4, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29614486/prevention-effect-of-antiplatelets-on-aneurysm-rupture-in-a-mouse-intracranial-aneurysm-model
#10
Tomo Suzuki, Yoshinobu Kamio, Hiroshi Makino, Kazuya Hokamura, Tetsuro Kimura, Tomohiro Yamasaki, Hisaya Hiramatsu, Kazuo Umemura, Hiroki Namba
BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) from intracranial aneurysm rupture results in significant morbidity and mortality. In the present study, we examined the effect of most widely used antiplatelet drugs, aspirin and cilostazol, on aneurysm rupture prevention using a mouse intracranial aneurysm model. MATERIALS AND METHODS: Intracranial aneurysms were induced by a combination of deoxycorticosterone acetate-salt and a single injection of elastase into the cerebrospinal fluid in mice...
April 3, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29609872/long-term-trends-in-antithrombotic-drug-prescriptions-among-adults-aged-80-years-and-over-from-primary-care-a-temporal-trends-analysis-using-electronic-health-records
#11
A Dregan, R Ravindrarajah, J Charlton, M Ashworth, M Molokhia
PURPOSE: This study aimed to estimate trends in antithrombotic prescriptions from 2001 to 2015 among people aged 80 years and over within clinical indications. METHODS: A prospective cohort study with 215,559 participants registered with the UK Clinical Practice Research Datalink from 2001 to 2015 was included in the analyses. The prevalence and incidence of antiplatelet and anticoagulant drugs were estimated for each year and by five clinical indications. RESULTS: The prevalence rate of antithrombotic prescriptions among patients aged over 80 years and diagnosed with atrial fibrillation increased from 53% in 2001 to 77% in 2015 (Ptrend <...
March 19, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29607737/dual-antiplatelet-therapy-after-percutaneous-left-atrial-appendage-occlusion-single-center-experience-with-the-amplatzer-cardiac-plug
#12
Philippe B Bertrand, Melanie Habran, Karlijn Kenis, Julie Lecomte, Linde Moonen, Didier Stroobants, Edouard Benit
BACKGROUND: Percutaneous left atrial appendage occlusion (LAAO) is an alternative to anticoagulation in atrial fibrillation patients at high bleeding risk. Dual antiplatelet therapy (DAPT) is generally recommended in the months following the procedure to prevent thrombotic complications. The aim of this study was to evaluate the safety and efficacy of DAPT after LAAO in a single-centre population of high bleeding risk patients. METHODS: All patients who received DAPT after LAAO using the Amplatzer Cardiac Plug at Jessa Hospital (Hasselt, BE) between February 2011 and October 2016 were included...
April 1, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29606934/vedolizumab-treatment-for-ulcerative-colitis-in-an-elderly-multimorbid-patient-with-hemophilia-a
#13
Holger Schäffler, Astrid Huth, Georg Lamprecht, Olaf Anders
The treatment of inflammatory bowel diseases (IBD) can be challenging, especially in elderly multimorbid patients. Since incidence and prevalence rates of IBD are rising steadily, treatment of older patients with relevant and also rare comorbidities will be of increasing relevancy for caregivers. Here we report on a 74-year-old multimorbid patient with severe ulcerative colitis (UC) and hemophilia A. Because of the chronic active disease, therapy with a tumor necrosis factor-α inhibitor was started. He suffered from a severe infectious complication (pneumonia) under therapy with infliximab...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29599812/study-of-pharmacodynamic-and-pharmacokinetic-interaction-of-bojungikki-tang-with-aspirin-in-healthy-subjects-and-ischemic-stroke-patients
#14
Jung-Hwa Yoo, Sung-Vin Yim, Byung-Cheol Lee
Background: Bojungikki-tang (BJIKT) is a widely used traditional herbal formula in China, Japan, and Korea. There have been reports that several herbs among BJIKT have interactions with antiplatelet drugs, such as aspirin. This study aimed to assess whether BJIKT interacts with aspirin in terms of pharmacokinetics (PK) and pharmacodynamics (PD) in healthy subjects and ischemic stroke patients. Methods: The phase I interaction trial was a randomized, open-label, crossover study of 10 healthy male subjects, and the phase III interaction trial was a randomized, placebo-controlled, parallel study of 43 ischemic stroke patients...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29599096/antithrombotic-therapy-trends-in-non-valvular-atrial-fibrillation-patients-undergoing-percutaneous-coronary-stent-implantation-results-from-a-survey-among-fellows-at-the-japanese-college-of-cardiology
#15
Daisuke Fukamachi, Atsushi Hirayama, Katsumi Miyauchi, Satoshi Yasuda, Hisao Ogawa, Hiroshi Ito, Hiroyuki Daida
BACKGROUND: Antithrombotic therapy with oral anticoagulants (OAC) in patients with atrial fibrillation (AF) after stent implantation, where dual antiplatelet therapy (DAPT) is also recommended, is not established. Antithrombotic therapies prescribed vary widely among cardiologists and may change year by year, according to the accumulation of new evidence. METHODS: A questionnaire-based survey concerning the antithrombotic therapy prescribed for OAC-treated AF patients who underwent stent implantation was conducted from 2014 to 2016...
March 26, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29593860/potential-drug-drug-interactions-with-direct-oral-anticoagulants-in-elderly-hospitalized-patients
#16
Heather L Forbes, Thomas M Polasek
Background: To determine the prevalence and nature of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in elderly hospitalized patients. Methods: This was a retrospective observational study. Inclusion criteria were: aged over 65 years; taking apixaban, rivaroxaban or dabigatran; and admitted to the Repatriation General Hospital between April 2014 and July 2015. A list of clinically relevant 'perpetrator' drugs was compiled from product information, the Australian Medicines Handbook, the Australian National Prescribing Service resources, and local health network guidelines...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29584740/panax-quinquefolius-saponins-combined-with-dual-antiplatelet-drug-therapy-alleviate-gastric-mucosal-injury-and-thrombogenesis-through-the-cox-pg-pathway-in-a-rat-model-of-acute-myocardial-infarction
#17
Na Kou, Mei Xue, Lin Yang, Ming-Xuan Zang, Hua Qu, Ming-Ming Wang, Yu Miao, Bin Yang, Da-Zhuo Shi
OBJECTIVES: Previous studies have found that Panax quinquefolius saponins (PQS) combined with dual antiplatelet therapy (DAPT) of aspirin and clopidogrel enhances antithrombotic effects while reducing gastric mucosal injury induced by DAPT. We investigated the effects of the combined drug therapy (PQS+DAPT) through the COX/PG pathways. METHODS: Acute myocardial infarction (AMI) was induced in Wistar rats by ligation of the left anterior descending (LAD) coronary artery, and the animals were randomly divided into Model, DAPT, and PQS+DAPT groups...
2018: PloS One
https://www.readbyqxmd.com/read/29582698/a-new-category-stent-with-novel-polyphosphazene-surface-modification
#18
Hiroyoshi Mori, Hiroyuki Jinnouchi, Chahal Diljon, Sho Torii, Atsushi Sakamoto, Frank D Kolodgie, Renu Virmani, Aloke V Finn
The COBRA-PzF™ (CeloNova BioSciences, Inc., TX, USA) is a new type of coronary stent composed of a cobalt chromium metallic backbone surrounded by a nanothin layer of Polyzene-F (PzF) without any added drug. Evidence from basic studies supports antithrombotic and anti-inflammatory properties for the PzF surface coating. Preclinical studies support the thromboresistance of PzF coated surfaces and clinical studies have shown good outcomes for patients receiving this device with very low rates of stent thrombosis...
March 27, 2018: Future Cardiology
https://www.readbyqxmd.com/read/29580113/platelet-biomechanics-platelet-bioenergetics-and-applications-to-clinical-practice-and-translational-research
#19
Mitchell J George, James Bynum, Prajeeda Nair, Andrew P Cap, Charles E Wade, Charles S Cox, Brijesh S Gill
The purpose of this review is to explore the relationship between platelet bioenergetics and biomechanics and how this relationship affects the clinical interpretation of platelet function devices. Recent experimental and technological advances highlight platelet bioenergetics and biomechanics as alternative avenues for collecting clinically relevant data. Platelet bioenergetics drive energy production for key biomechanical processes like adhesion, spreading, aggregation, and contraction. Platelet function devices like thromboelastography, thromboelastometry, and aggregometry measure these biomechanical processes...
March 26, 2018: Platelets
https://www.readbyqxmd.com/read/29576335/limited-adherence-to-peripheral-arterial-disease-guidelines-and-suboptimal-ankle-brachial-index-reliability-in-dutch-primary-care
#20
David Hageman, Niels Pesser, Lindy N M Gommans, Edith M Willigendael, Marc R H M van Sambeek, Ellen Huijbers, Aafke Snoeijen, Marc R M Scheltinga, Joep A W Teijink
OBJECTIVE/BACKGROUND: The Dutch College of General Practitioners' guideline on peripheral arterial disease (PAD) provides clear recommendations on the management of PAD. An ankle brachial index (ABI) measurement, prescription of antiplatelet drugs and statins, and supervised exercise therapy (SET) for intermittent claudication (IC) are advised. The aims of this study were to determine the adherence of general practitioners (GPs) to their own guideline on PAD and to evaluate the reliability of primary care ABI measurements...
March 23, 2018: European Journal of Vascular and Endovascular Surgery
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